Managing your dog’s pain: Pharmaceutical options and maskers of pain by Dr. James St.Clair
Since this entire blog series has been all about pain in dogs, our last discussion needs to be about what drugs are available to manage pain. Most of these you may be familiar with, but there are two important concepts that I want you to take away.
Non-Steroidal Anti-Inflammatories
The first and most obvious one is the group of drugs referred to as NSAIDs, or Non-Steroidal Anti-Inflammatories. Included in this group is aspirin, but I would strongly encourage you to avoid any long-term use of this and instead focus on utilizing the more targeted drugs developed specifically for dogs. The most popular in this group, hands down, is still Rimadyl®, which is the brand name for the drug carprofen. Since going off patent a few years ago, carprofen is now available under many different names, but you will still always see the name carprofen on the bottle. It is available in 25mg, 75mg, and 100mg tablets.
Also in this group are the following drugs (brand name first, drug name second):
- Deramaxx® (deracoxib)
- Previcox® (firocoxib)
- Metacam® (meloxicam)—also now available in a generic version
Depending on your veterinarian and their experience, they may choose one brand over the other, but all of them are potentially life-changing for a dog in pain. Like every drug, this group of NSAIDs can have potential adverse effects, so discuss any risks with your veterinarian.
Important takeaways
- It has been shown that in some cases you may need to “find” the right NSAID for your dog; therefore if one does not seem to help that much, you may want to mention to your veterinarian that you would like to try a different one.
- This also goes for any adverse effects. Just because your dog does not tolerate one does not mean he or she will not tolerate any of them.
- All of these drugs should be given after your dog has food in their belly. If your dog is not eating, then absolutely do not give any of these medications to them and call your veterinarian.
Opioids
If or when your dog needs additional pain management, your veterinarian may introduce some opioids into the mix. This group of drugs can really change the game when it comes to effective pain management. They are in most cases extremely well tolerated and on the whole very safe. The most common opioid prescribed for daily use in veterinary medicine is Tramadol. It is available in 50mg tablets, though it can be compounded into smaller dosages for smaller dogs. It also has a very wide prescribed safety margin in terms of dosing.
Other commonly used opioids are Codeine, Fentanyl, Hydromorphone, Hydrocodone, and Butorphanol. Leave it up to your veterinarian to decide which would be best for your dog.
Other Pain Drugs
There is one honorable mention that I would like to add here. It is Gabapentin, also known as Neurontin®. This drug is actually an anti-seizure medication that also has been used in managing chronic pain in dogs and cats.
Final Thoughts
Lastly I want to leave you with two important concepts that I think are vital. The first is the important of understanding synergism. Synergism is defined as the interaction or cooperation of two substances that together produce a greater effect than the sum of their separate effects. The reason I want you to understand this concept is that often the combination of drugs, even occasionally at lower dosages, can have a greater effect on relieving your dog’s pain than simply relying on one drug alone. This is a conversation that your veterinarian would appreciate having with you.
The second concept is one that I warmly named “Tweaking.” Strange, right? The big idea is this—when it comes to joint disease you must accept the fact that this is a progressive disease; therefore it is going to worsen over time. It is essential that you be open to “Tweaking” your dog’s supplements and medications along that way. For my patients I always start with my natural options like joint supplements and Omega 3’s. From there, in the future when I need to, I will add an NSAID. Then again, when I need to, I will add an opioid or a combination of opioids and Gabapentin, depending on what I think will best suit that particular dog and condition. Throughout all of this there is still the need to focus on exercise, stretching, massage, and muscle development.
Ultimately, my goal is to make sure that my dogs and my clients’ dogs are maintaining the absolute best quality of life that they can realize. If you found this information useful, please make sure to share it with your friends who have dogs or on social media. The goal is to help any dog who potentially is suffering silently in pain. Also it would be awesome if you would leave a comment in the comments section below to let the amazing founders and supporters of The Grey Muzzle Organization know that you found this information useful.
